A Rare Case of Slipping of the Upper Femoral Epiphysis Accompanied by Pan-hypopituitarism due to Pituitary Tumor

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A rare case of slipping of the upper femoral epiphysis accompanied by pan-hypopitutarism due to pituitary tumor was reported. In Japanese literature, five these cases have been reported. A 14-year-old girl was admitted in our department complaining of hip pain and limping. Drehmann's sign was positive. Roentgenogram showed posterior slip of the upper femoral epiphysis at an angle of 30 degrees. On the further examination, ballooning of the pituitary fossa was observed on cranial x-ray, and pituitary tumor was pointed out on C-T scanning. On endocrine examination, pituitary, thyroid, adrenocortical and sex hormones were all decreased. The tumor was removed neurosurgically, and diagnosed histlogically as ectopic pinealoma. Now the patient is 17 years old taking supplementary hormone therapy, and is asymptomatic is her left hip. Roentgenographically, slipping of the epiphysis was not increased, because spontaneous epiphyseal closure has occurred after the theraphy.In conclusion, it is said that secondary insufficiencies of the target organs due to pan-hypopituitarism were the major causes of the slipped femoral epiphysis.
西日本整形・災害外科学会の論文